Gender differences in the prevalence and treatment of coronary chronic total occlusions

Catheter Cardiovasc Interv. 2016 May;87(6):1063-70. doi: 10.1002/ccd.26330. Epub 2015 Nov 25.


Background: Gender differences exist in the presentation and outcomes of patients with coronary artery disease (CAD). Our study objective was to compare gender differences in prevalence, co-morbidities, and revascularization treatment in CAD patients with chronic total occlusions (CTOs).

Methods: A retrospective analysis using the Canadian Multicenter CTO Registry, which included 1,690 consecutive CTO patients identified at coronary angiography and a control group of 7,682 non-CTO patients.

Results: The prevalence of women in the CTO group was significantly lower compared to the control group (19% vs. 30%, P < 0.001). Within the overall CTO group, women were significantly older than men (70 ± 12 vs. 66 ± 11 years, P < 0.001) with more comorbidities, including hypertension and heart failure. Rates of PCI in the CTO group were similar between gender (10%), however, women with CTO were treated significantly less by CABG compared to men (19% vs. 27%, P = 0.003). Moreover, compared to male patients, significantly fewer women undergoing CABG had revascularization of the CTO artery (84% vs. 93%, P = 0.03). Multivariable analysis indicated that female gender (along with age, chronic renal failure, prior MI and cerebro-vascular disease) were independent predictors for not receiving CABG treatment for CTO.

Conclusions: Female gender differences exist in CTO patients with both lower prevalence of CTOs at angiography and lower revascularization rates of CTOs by CABG. © 2015 Wiley Periodicals, Inc.

Keywords: coronary artery disease; gender; outcomes/studies; percutaneous coronary intervention.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Canada / epidemiology
  • Chronic Disease
  • Coronary Angiography
  • Coronary Occlusion / diagnosis
  • Coronary Occlusion / epidemiology*
  • Coronary Occlusion / surgery
  • Female
  • Humans
  • Male
  • Percutaneous Coronary Intervention*
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Registries*
  • Risk Assessment / methods*
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • Time Factors